Introduction The Mississippi Delta is predominantly rural and ranks among the US regions with the highest obesity rates. Throughout the US, rural and low-income communities have limited access to healthy foods. Given the interrelation between the quality of the food environment and the healthfulness of diets and obesity rates, the food environment is an important public health concern in these communities. Methods We conducted a retail assessment in July 2019 in the Delta region of Mississippi and evaluated prices and availability of healthy foods at Supplemental Nutrition Assistance Program–accepting retail establishments using the validated Market Basket Assessment Tool. We used regression analysis to identify differences in prices and availability of healthy foods across food retail formats. Results The healthy foods availability and quality score for convenience stores, which comprise the highest proportion of store formats in the region, was 70% lower than for supermarkets. Compared with the prices at supermarkets, the prices at convenience stores were 48% higher for grains, 35% higher for fruit and vegetables, 73% higher for meats, and 95% higher for beans, seeds, and nuts. The healthfulness of foods available at dollar stores was also lower than the healthfulness at supermarkets, but prices were generally similar. Conclusion The availability of supermarkets and grocery stores was limited in the study area, but the concentration of convenience stores was high. Overall, access and affordability of healthy foods were restricted in the counties studied; these findings are useful for intervention development.
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